Thomas Engels was named Acting Administrator for the Health Resources and Services Administration (HRSA) on August 1, 2019 and will oversee the execution of HRSA’s $11.7 billion annual budget, including the Health Center Program, the National Health Service Corps and NURSE Corps, the Ryan White HIV/AIDS Program and more. Before joining HRSA six months ago as Principal Deputy Administrator, Mr. Engels was Deputy Secretary of the Wisconsin Department of Health Services from 2015 to 2019. He was an active member of the Governor’s Task Force on Opioid Abuse and also chaired the Governor’s Human Resources Shared Services Executive Committee. Read more. Mr. Engel’s predecessor, Dr. George Sigounas, has been reassigned to an advisor role in the office of the HHS Secretary.

The Pennsylvania Departments of Human Services and Aging have announced a helpline for families in kinship care situations, including grandparents raising their grandchildren because of the opioid crisis. The helpline is staffed by Kinship Navigators – compassionate, knowledgeable social service professionals prepared to help families locate, understand, and access resources that may be able to help them. Kinship Navigators will connect grandparents and other relatives who are raising children with resources such as health, financial and legal services, support groups, training, and parenting advice. They will help families locate physical or behavioral health services, enroll the child in school, find support groups and other services designed to help caregivers. They will also be available to help families apply for federal, state, and local benefits such as Social Security, public assistance or CHIP. In addition, a website of resources is set to launch later this year. KinConnector can be reached by calling 1-866-KIN-2111 (1-866-546-2111) Monday – Thursday 9:00 am – 10:00 pm and Friday 9:00 am – 5:00 pm.

The Centers for Disease Control and Prevention (CDC) examined trends and characteristics of prescriptions for naloxone, a drug that can help prevent overdose deaths by reversing the effects of opioids.  By analyzing data from retail pharmacies across the U.S., the CDC found that the number of naloxone prescriptions increased substantially from 2012 to 2018 with an increase of 106 percent from 2017 to 2018 alone.  The CDC Guideline for Prescribing Opioids for Chronic Pain recommends prescribing naloxone for patients who are at high risk for overdose, but the new research found that only one naloxone prescription was dispensed for every 69 high-dose opioid prescriptions – with the lowest rate in rural counties.  Last week, the CDC’s National Center for Health Statistics released a brief, Urban-Rural Differences in Drug Overdose Death Rates, showing rates were higher in urban areas for overdose deaths involving heroin, synthetic opioids, and cocaine, but higher in rural for natural and semisynthetic opioids, and psychostimulants with abuse potential.   Click here to access the full report.

On August 8, 2019, the Health Resources and Services Administration’s (HRSA) Federal Office of Rural Health Policy announced awards of over $111 million to 96 rural organizations across 37 states as part of its multi-year Rural Communities Opioid Response Program (RCORP) initiative.  These funds, which also include support for an evaluation of the initiative, will strengthen rural communities’ capacity to provide needed substance use disorder prevention, treatment, and recovery services and build the evidence base for interventions that are effective in rural settings.

• Eighty rural consortia received RCORP-Implementation awards of $1 million each to implement a set of prevention, treatment, and recovery activities that align with the U.S. Department of Health and Human Services’ Five-Point Strategy to Combat the Opioid Crisis.
• Twelve recipients received RCORP-Medication-Assisted Treatment (MAT) Expansion awards of up to $725,000 each to establish and/or expand MAT in rural health clinic, hospital, Health Center Look-Alike, and tribal settings.
• Three recipients received $6.6 million each to establish Centers of Excellence on Substance Use Disorders (CoEs) that will identify, translate, disseminate, and implement evidence-based and promising practices related to the treatment for and prevention of substance use disorder (SUD).

The full announcement can be accessed here.

Priscilla Bogema lives in a rural town called McGregor, Minn., in a part of the state that has more trees and lakes than people.  She came here about 20 years ago seeking solitude during a major crisis in her life. She had just gotten divorced and was dealing with some health problems. “So I came to a place where nobody could see me,” she says.

Now, Bogema is in her 60s, frail and mostly confined to her house. Her arthritis and other health problems have limited her mobility. She struggles with the upkeep of her home and yard. She drives into town once a week for groceries and a movie with other seniors. But she doesn’t have close friends she sees regularly and her children and grandchildren only visit once every few months.

The solitude she once sought is no longer as comforting. “It can get lonely, very lonely,” she says.

According to a recent poll by NPR, the Robert Wood Johnson Foundation and the Harvard T.H. Chan School of Public Health, Bogema is one of about 2.5 million rural residents (about 7% of the total rural population) who say they have no friends or family nearby to rely on. An additional 14 million (about 39%) say they only have a few people. Like Bogema, many feel isolated.

McGregor, Minn., is one of 18 communities in north-eastern part of the state that is participating in a program that addresses loneliness and social isolation by connecting the young with the old.

Meredith Rizzo/NPR

People in rural areas report “feeling lonely or left out,” says Carrie Henning-Smith, the deputy director of the University of Minnesota Rural Health Research Center and one of the authors of a recent study on rural isolation, despite the fact that rural communities often have stronger social networks than urban ones. She notes that many communities have become more socially isolated in recent years as rural economies have declined and young people moved away.

Social isolation is increasingly recognized as a public health issue. Studies show that isolation and loneliness puts people at a higher risk of long term physical and mental health problems, including premature mortality. And Henning-Smith’s preliminary research suggests that in rural areas, isolation can reduce people’s ability to meet daily needs, like access to health care and food.

A group in northeastern Minnesota is tackling this problem in a novel way: They’re trying to reconnect a fragmented social fabric by bringing together generations to support each other — kids and the elderly.

McGregor is one of 18 rural communities running the program, called AGE to age. It connects more than 4,000 youth with almost 2,500 older adults annually.

The initiative is not just geared to help the elderly — the support runs both ways. It also helps children and young people in these communities feel more supported, giving them work experience and mentors. Children and seniors work on projects together — the kind of activity varies from community to community, and can range anywhere from participating in a reading club, to building and maintaining a community garden, to helping local food pantries, to working on art projects. Along the way, they develop meaningful relationships that can last beyond the program.

The full article can be accessed here.

The Pennsylvania Action Coalition published a seven minute preview for the “At the Core of Care” podcast series, which features stories of innovative nurses and the people and communities they serve. Season One launches this September. Subscribe now on Apple, Google, Stitcher, or wherever you get your podcasts.  Subscribe now

During the week of July 29, 2019, Pennsylvania Gov. Tom Wolf by executive order announced that an overhaul of the state services and systems to protect the most vulnerable Pennsylvanians will begin. Governor Wolf’s “Protection of Vulnerable Populations” Executive Order establishes an Office of Advocacy and Reform, maintained by the governor’s office with an executive director, creates a new Child Advocate position and integrates the Long-term Care Ombudsman. It also establishes a Council on Reform, with 25 voting members appointed by Gov. Wolf to support this effort by looking at protecting vulnerable populations from three perspectives: prevention and diversion, protection and intervention, and justice and support. Both the Council on Reform and the Office of Advocacy and Reform will identify reforms needed for Pennsylvania to better protect and support individuals relying upon services and assistance from the commonwealth.  The governor also shared his intent to pursue extensive regulatory and legislative actions.

During the week of July 29, 2019, the Centers for Medicare and Medicaid Services (CMS) released rules finalizing Medicare payment adjustments for skilled nursing facilities (SNFs), hospices, and inpatient rehabilitation (IRFs) and psychiatric (IPFs) facilities for FY 2020. Under the final rules, Medicare payments to SNFs will increase by 2.4% in FY 2020 relative to FY 2019; payments to IPFs by 1.5%, or $65 million; payments to IRFs will increase by 2.5%, or $210 million; and payments for hospice facilities will increase by 2.6%, or $520 million.

During the week of July 29, 2019, the Centers for Medicare and Medicaid Services (CMS) announced the average basic premium for Medicare Part D plans is projected to decline in 2020 for the third year in a row, falling from $32.50 this year to $30 next year. CMS Administrator Seema Verma said the downward trend in Part D premiums stems from “actions that CMS has taken to strengthen the Medicare prescription drug program.”

During the week of July 29, 2019, the Centers for Medicare and Medicaid Services (CMS) issued its Inpatient Prospective Payment System final rule for fiscal year (FY) 2020, which aims to address payment disparities for rural and urban health facilities and increase add-on payments for emerging technology and therapies. The 2,273-page final rule will affect about 3,300 acute care facilities and is expected to increase total Medicare spending on inpatient hospital services, including capital, by about $3.8 billion in FY 2020 when compared with FY 2019.